Evidence map›Paper›PMID 29102781›Full record

ArticleBreast (Edinburgh, Scotland)2018

Outcomes of immediate versus delayed breast reconstruction: Results of a multicenter prospective study.

Alfred P Yoon, Ji Qi, David L Brown, Hyungjin M Kim, Jennifer B Hamill, Jessica Erdmann-Sager, Andrea L Pusic, Edwin G Wilkins

Abstract readComparative StudyMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Breast (Edinburgh, Scotland), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 86 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
86citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

86 citing papers in PubMed, 4 syntheses or guidelines pooled it.

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26 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Alfred P YoonDivision of Plastic and Reconstructive Surgery, University of Michigan, 1500 E. Medical Center Dr., Ann Arbor, MI 48109, USA.
Ji QiDivision of Plastic and Reconstructive Surgery, University of Michigan, 1500 E. Medical Center Dr., Ann Arbor, MI 48109, USA.
David L BrownDivision of Plastic and Reconstructive Surgery, University of Michigan, 1500 E. Medical Center Dr., Ann Arbor, MI 48109, USA.
Hyungjin M KimCenter for Statistical Consultation and Research, University of Michigan, Ann Arbor, MI 48109, USA.
Jennifer B HamillDivision of Plastic and Reconstructive Surgery, University of Michigan, 1500 E. Medical Center Dr., Ann Arbor, MI 48109, USA.
Jessica Erdmann-SagerDivision of Plastic and Reconstructive Surgery, Brigham and Women's Hospital, 20 Patriot Place, Foxborough, MA 02035, USA.
Andrea L PusicMemorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA.
Edwin G WilkinsDivision of Plastic and Reconstructive Surgery, University of Michigan, 1500 E. Medical Center Dr., Ann Arbor, MI 48109, USA. Electronic address: ewilkins@med.umich.edu.

Funding

X-RAY CRYSTALLOGRAPHYP30CA008748 · NCI · SLOAN-KETTERING INSTITUTE FOR CANCER RES · PI Nicholas D Socci · 1985 to 2026
$347.4M
Mastectomy Reconstruction Outcome Consortium (MROC Study)R01CA152192 · NCI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI PUSIC, ANDREA LOUISE, WILKINS, EDWIN G. · 2011 to 2015
$4.9M
NCI NIH HHS P30 CA008748NCI NIH HHS R01 CA152192
6 · The paper itself

Abstract

backgroundPrevious studies suggest that immediate reconstruction following mastectomy produces superior results over delayed procedures. However, for medical or oncological reasons, some patients may be poor candidates for immediate reconstruction. We compared complications and patient-reported outcomes between immediate and delayed breast reconstructions in a prospective, multicenter study.

methods1957 patients (1806 immediate, 151 delayed) met eligibility criteria. Demographic data, major complications, infections, and reconstructive failure rates were evaluated. Patient-reported outcomes were assessed with BREAST-Q, PROMIS, and EORTC QLQ-BR23 surveys, pre- and two years post-operatively. Subscale scores were compared across cohorts using mixed-effects regression models, controlling for patient characteristics and hospitals.

findingsComplete data were available in 1639 immediate and 147 delayed reconstruction patients. There were significant baseline differences between immediate and delayed cohorts in age, BMI, prevalence of diabetes, lymph node management, use of radiation, and chemotherapy. Controlling for clinical covariates, the delayed group had lower odds of any (OR 0.38, p < 0.001) and major (OR 0.52, p = 0.016) complications, compared with immediate patients. Furthermore, delayed reconstruction was associated with a significantly lower failure rates (6% vs. 1.3%, p = 0.032). However, multivariate analyses found no significant differences in patient satisfaction or in psychosocial, sexual, or physical well-being at two years.

conclusionsCompared with immediate techniques, delayed reconstruction following mastectomy was associated with lower rates of overall and major complication, while providing equivalent patient satisfaction and quality of life benefits. Although immediate reconstruction is still the preferred choice of most patients and surgeons, delaying reconstruction does not appear to compromise clinical or patient-reported outcomes.

Indexed as

AdultBreast NeoplasmsFemaleHealth StatusHumansMammaplastyMastectomyMiddle AgedPatient Reported Outcome MeasuresPatient SatisfactionPostoperative ComplicationsProspective StudiesQuality of LifeSexual BehaviorSurveys and QuestionnairesTime FactorsBREAST-QDelayed breast reconstructionImmediate breast reconstructionMastectomyMROCPatient reported outcomes

Identifiers

PMID29102781
PMCPMC5902735

What OpenQuestion holds

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LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.